Provider Demographics
NPI:1457608457
Name:SNYDER, GRETCHEN DARLENE
Entity Type:Individual
Prefix:MISS
First Name:GRETCHEN
Middle Name:DARLENE
Last Name:SNYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 E MCDOWELL RD
Mailing Address - Street 2:APARTMENT #2131
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-7475
Mailing Address - Country:US
Mailing Address - Phone:314-591-8960
Mailing Address - Fax:
Practice Address - Street 1:6805 N 125TH AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85307-2402
Practice Address - Country:US
Practice Address - Phone:623-742-3956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant